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Evaluation of growth hormone secretion in children with juvenile rheumatoid arthritis and short stature
1Department of Pediatrics, Creighton University School of Medicine, Omaha, Nebraska, USA.
Insights
Children with juvenile rheumatoid arthritis (JRA) may experience short stature due to low 24-hour growth hormone (GH) secretion. Treatment with recombinant GH showed limited growth improvement, suggesting a poor response to GH therapy in these patients.
Area of Science:
- Pediatric Endocrinology
- Rheumatology
- Skeletal Development
Background:
- Juvenile rheumatoid arthritis (JRA) is associated with delayed skeletal development.
- Previous assessments of growth hormone (GH) in JRA patients relied on single blood measurements.
- The potential for GH deficiency in short children with JRA requires further investigation.
Purpose of the Study:
- To evaluate 24-hour GH pulsatile secretion in children with short stature and JRA.
- To determine if impaired GH secretion contributes to growth delay in JRA.
- To assess the response to recombinant human GH (rhGH) therapy in this cohort.
Main Methods:
- Assessed 24-hour serum GH secretion in six children with JRA and short stature.
- Administered 24-month trials of rhGH to two participants.
- Monitored growth response during rhGH therapy.
Main Results:
- Three of the six JRA patients exhibited abnormally low 24-hour GH secretion.
- Two patients receiving rhGH showed only marginal growth acceleration over 24 months.
- This suggests a potential lack of adequate physiologic response to exogenous GH.
Conclusions:
- Children with JRA and persistent short stature may have underlying GH secretion issues.
- The response to exogenous rhGH administration appears limited in this population.
- Further research is needed to understand GH dynamics and optimize growth management in JRA.
Abstract:
Children with juvenile rheumatoid arthritis (JRA) often exhibit delayed skeletal development. Previous evaluations of growth hormone (hGH) levels in these children have used single-value blood determinations. We sought to extend information on possible hGH deficiency in children with short stature and JRA by measuring 24-hour hGH pulsatile secretion. Five children with JRA were identified as having a height less than the 3rd percentile, and one child with a height at the 25th percentile. Three of these had abnormally low 24-hour serum hGH secretion. Two underwent a 24-month trial of human recombinant hGH; both exhibited only marginally accelerated growth. These results suggest that children with JRA and persistent short stature may have low hGH secretion without an adequate physiologic response to exogenous hGH administration.